DIASTOLIC BLOOD-PRESSURE AS A DETERMINANT OF DOPPLER LEFT-VENTRICULAR FILLING INDEXES IN NORMOTENSIVE ADOLESCENTS

[摘要] Alterations in left ventricular filling can occur with aging and in patients with hypertension, ischemic heart disease, congestive and hypertrophic cardiomyopathy and congenital heart disease. This study examines the effects of blood pressure on left ventricular diastolic filling indexes measured by Doppler ultrasound technique in 47 young normotensive adolescents (mean age 13 years). Left ventricular filling was assessed by Doppler peak early and late diastolic transmitral flow velocities, early and late diastolic flow velocity integrals and early diastolic deceleration. Systolic blood pressure did not correlate with any of the Doppler filling indexes, alghough it was related to echocardiographic left ventricular mass (r = 0.44, p < 0.005). Diastolic blood pressure did not correlate with left ventricular mass; however, it was inversely related to peak early diastolic flow velocity (r = -0.44, p < 0.005), early diastolic flow velocity integral (r = -0.40, p < 0.01) and early diastolic deceleration (r = -0.32, p < 0.05). The ratio of late to early peak filling (A/E) was directly related to diastolic blood pressure (r = 0.48, p < 0.001). Examination of electrocardiograms showed that there was a stronger correlation between A/E ratio and diastolic blood pressure (r = 0.63) in 22 subjects with bimodal P waves in lead V1 than in subjects with unimodal P waves (r = 0.45). These findings demonstrate that, in normal adolescents with bimodal P waves in lead V1, the pattern of left ventricular filling is related to the level of diastolic blood pressure. These changes are independent of left ventricular hypertrophy and may be very early manifestations of prehypertensive alterations in left ventricular diastolic function.

[发布日期] 1987-12-01